Innovation and Efficiency for a Pediatric ED

The Challenge

Valley Children' s Hospital Emergency Department is housed in a tertiary care pediatric hospital which contains over 356 in-patient beds and serves 118,000 patients per year with a service area stretching from Sacramento to Bakersfield, California. The expansion in volume in the ED over the years required use of outpatient clinic space at night in order to see patients, with resultant long wait times and poor customer and staff satisfaction.

The Solution

To accommodate the increased volume, the hospital decided to expand its ED. USACS used a state-of-the-art computerized flow modeling system customized to the VCH emergency department to accurately predict which patterns of patient flow and staff utilization would optimize the ED space. USACS determined that, despite the expansion, additional full-time nursing positions were not needed. USACS consulted with national leaders in ED renovation, as well as with physician and nursing leaders to create a renovated ED focused on the patient experience and efficiency. When the doors to the new ED opened, customer praise quickly followed, and the new ED capacity eliminated the need for after-hour clinics.

The Results

The LWOT rate has been maintained at less than 1% since opening the doors to the new ED. While the expanded ED provides additional beds to help handle volume, implementing USACS’s patient flow model practices has streamlined the ED experience, increasing patient satisfaction and staff morale. USACS’ unique triage practices enable all patients to receive an evaluation by a physician quickly; even patients with routine complaints don’t wait to be seen. Patient satisfaction has risen dramatically to the 80th percentile and customer praise for the ED has never been better.

Summary

Sustained operational excellence is always a challenge because success brings with it increased customer volume. Rising volumes present a challenge to even the best flowing EDs, and ED renovations don’t guarantee operational strength. Only with innovation, foresight, and experience can ED flow patterns be optimized. USACS will continue to bring to our partners the strategies and operational tactics needed to achieve excellence in emergency care and operations.